Regional Interdependence In Treatment Of The Elbow: Difference between revisions
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== Wrist Manipulation for lateral epicondylagia<br> == | == Wrist Manipulation for lateral epicondylagia<br> == | ||
== | == Carpal Mobilization for Cubital Tunnel Syndrome == | ||
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== <br>• Wrist mobilization <br> Clinical Presentation<br>1. Patients with lateral epicondylitis defined as <br>A. Pain on lateral side of the elbow that is aggravated by both pressure applied to the lateral epicondyle and with resisted extension of the wrist <br>B. Symptoms for at least 6 weeks, but not longer than 6 months<br>C. Patients excluded from treatment if bilateral complaints, definite decrease in pain in the last 2 seeks, severe neck or shoulder problems <br> Intervention Strategy <br>1. The patient rests their forearm of their affected arm on the table with the palmar side of the hand facing down. The therapist sits at right angles to the patient’s affected side, gripping the patient’s scaphoid bone between their thumb and index finger. The therapist then places the thumb and index finger of his other hand on top of his hand gripping the scaphoid. The therapist performs the manipulation by extending the patient’s wrist dorsally while at the same time manipulating the scaphoid bone ventrally. <br> <br> Outcomes of intervention <br>1. The wrist manipulation was more effective at increasing global improvement than combined treatment of ultrasound, friction massage, and muscle strengthening and stretching exercises. In addition, the manipulation was also superior at decreasing pain scores after 6 weeks of intervention. <br>2. Measures of pain free grip force, maximum grip force, and pressure pain threshold were not found to be significantly different between manipulation and combined treatment in this study. However, these findings may be due to a small number of subjects. <br>3. Additional studies done on the effectiveness of wrist manipulation in the treatment of lateral epicondylitis are needed 4 == | == <br>• Wrist mobilization <br> Clinical Presentation<br>1. Patients with lateral epicondylitis defined as <br>A. Pain on lateral side of the elbow that is aggravated by both pressure applied to the lateral epicondyle and with resisted extension of the wrist <br>B. Symptoms for at least 6 weeks, but not longer than 6 months<br>C. Patients excluded from treatment if bilateral complaints, definite decrease in pain in the last 2 seeks, severe neck or shoulder problems <br> Intervention Strategy <br>1. The patient rests their forearm of their affected arm on the table with the palmar side of the hand facing down. The therapist sits at right angles to the patient’s affected side, gripping the patient’s scaphoid bone between their thumb and index finger. The therapist then places the thumb and index finger of his other hand on top of his hand gripping the scaphoid. The therapist performs the manipulation by extending the patient’s wrist dorsally while at the same time manipulating the scaphoid bone ventrally. <br> <br> Outcomes of intervention <br>1. The wrist manipulation was more effective at increasing global improvement than combined treatment of ultrasound, friction massage, and muscle strengthening and stretching exercises. In addition, the manipulation was also superior at decreasing pain scores after 6 weeks of intervention. <br>2. Measures of pain free grip force, maximum grip force, and pressure pain threshold were not found to be significantly different between manipulation and combined treatment in this study. However, these findings may be due to a small number of subjects. <br>3. Additional studies done on the effectiveness of wrist manipulation in the treatment of lateral epicondylitis are needed 4 == |
Revision as of 04:41, 12 November 2012
Regional Interdependence of manipulation on elbow pain[edit | edit source]
Definition: Treatment directed at one area of the body to ellicit changes in another[edit | edit source]
-in addition to treatment directed at the elbow, patients with elbow pain may benefit from treatment directed at the cervical or thoracic spine, elbow, and/or wrist.[edit | edit source]
I.Treatment techniques[edit | edit source]
- Lateral epicondylitis
Cervical (link to spot within this page) (Patients - Treatments - Video - References)
CT (Patients - Treaments - Video - References)
Thoracic (Patients - Treatments - Video - References)
Wrist (Patients - Treatments - Video - References)
- Cubital tunnel
Carpal Mobilization (Patients - Treatments - Video - References)
- Radial Nerve entrapment
Median and Radial Nerve mobilization (Patients - Treatments - Video - References)
Outcomes
[edit | edit source]
Pain |
Pain free Grip strength |
Pressure pain threshold | Disability | Perception of change | Global improvement | Max grip force | Carpal mobility | Elbow flexion test | |
Cervical | X | X | |||||||
CT | X | X | X | X | |||||
Throacic | X | ||||||||
Wrist |
X | X | X | X | X | ||||
Carpal mobilization | X | X | X | ||||||
Medain/Radial Nerve Mob | X | X |
Cervical Thrust manipulation technique for lateral epicondylagia[edit | edit source]
- Patient supine with neck in nuetral
- Physical therapist positions neck into rotation and contralateral flexion
- High velocity low amplitude (HVLA) thrust manipulation directed superior and medial towards contralateral eye
Cervical Thrust Manip Video
Cervico-Thoracic Manipulation Technique for lateral epicondylagia[edit | edit source]
- Non-thrust grade III and IV PPIVM and PAVM directed at impaired segment
Done in combination the following:
- Stretching wrist extensors strengthening wrist and forearm and mobilizations of elbow/wrist
CT Manip Video
Thoracic Manipulation for lateral epicondylagia
[edit | edit source]
- Fill me in!
Wrist Manipulation for lateral epicondylagia
[edit | edit source]
Carpal Mobilization for Cubital Tunnel Syndrome[edit | edit source]
- Fill me in